MILWAUKEE - Tammy Worthington, a licensed nurse practitioner, was horrified at first.
Quadriplegics smashing wheelchairs into each other, tumbling out of their only means of moving around? All in the name of a sport?
"Watching guys fall on their heads was too much for me to handle," Worthington said.
Eight years later, she's team manager of the Milwaukee Iron, one of about 40 quad rugby teams in the nation.
"Some people are called ambulance chasers, I'm a wheelchair chaser," said Worthington, now a registered nurse.
That's how she snagged former three-sport athlete Harvey Ross. He was about to see Denzel Washington's newest movie this spring when she and team captain Dan Lehmann approached him in a local mall.
The 34-year-old Ross had been a quadriplegic since being shot a few months after graduating from high school.
"After my injury, I didn't do too much," said Ross, who was shot by his then-girlfriend's father. The bullet lodged in his spine. "I sat in the house a lot and I missed sports. The only sports I really played was on Playstation, video games."
Ross' interest in quad rugby mirrors a national trend since the niche documentary Murderball came out in 2005, which followed the rivalry between the U.S. and Canadian squads.
The sport allows those with limited arm and leg function to participate in an activity that needs less coordination than wheelchair basketball and less grip than wheelchair tennis.
"There's definitely an increase in playing, and I put it squarely on the shoulders of that film," said Ed Hooper, president of the United States Quad Rugby Association. "It rejuvenated the entire sport."
Hooper said the sport faded after medical privacy laws changed in 2003.
"We used to be able to go to a rehab center and say, 'What's the quad situation,' so to speak," he said. "Unless you can have hands on to rehab centers and go in and actually almost personally pitch these people, they get out of there and never really hear about the sport."
Now the association is growing again. Hooper expects there to be 41 teams this year, seven more than last year, including new squads in Washington, New York, San Antonio and Charlotte, N.C.
Each team must have at least four players. The Milwaukee Iron has 14 players. It began competitive play in 2000 and plays host to a tournament Nov. 11-12.
It's fairly easy to understand the game. Four players per side pass and dribble a volleyball around while banging their modified wheelchairs into each other.
Teams score a point each time two wheels of their chair cross the goal line when a player possesses the ball. Games last four quarters, 8 minutes each. A 3-minute overtime settles ties.
Lehmann, the Milwaukee Iron captain, said no one is looking for sympathy. All the players have their own reasons for playing, and Lehmann, also injured in a diving accident, said his biggest goal is to get quadriplegics out of motorized wheelchairs and into ones they push themselves.
"Because you're reaching to catch a ball or coming over to get one, it really helps you with everyday living stuff," said Lehmann. "You use muscles you never even knew you had."
Lehmann said once he gets a person to a practice, it's only a matter of minutes before they're participating.